CARE HOMES FOR OLDER PEOPLE
Lindenwood Residential Care Home 208 Nuthurst Road New Moston Manchester M40 3PP Lead Inspector
Lillian McMullen Unannounced Inspection 15th December 2005 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Lindenwood Residential Care Home Address 208 Nuthurst Road New Moston Manchester M40 3PP Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0161 681 4255 Ann Catherine Smith Maureen Philomena Murphy Andrea Hudders Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. Staffing levels must be regularly assessed and increased if necessary depending on service users assessed needs. The service should, at all times, employ a suitably qualified and experienced manager who is registered with the NCSC. Personal care only is provided for a maximum of 16 older people Staffing at the home must comply at all times with the minimum levels set out in the Residential Forum Guidelines for staffing in Care Homes for Older People. 2nd November 2004 Date of last inspection Brief Description of the Service: Lindenwood is an established care home providing personal care only for up to 16 older people. The property is a two storey detached house that has been extended. It is set within its own grounds overlooking the local park area. The property is accessible via steps and ramps. There is a large well-maintained garden to the rear of the property, which is also accessible via ramps. There is parking to the front of the property for approximately six vehicles. The property is situated to the North of Manchester City Centre near the boundary of Oldham. It is close to local amenities including shops, public library, post office and local pubs. There are good public transport links to Manchester and Oldham. Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 10.30 am and took place over 6 hours. The Inspector spoke to 3 staff members, six residents, two relatives, a district nurse, the registered manager and the homeowner. Part of the inspection was spent on looking at staff recruitment procedures together with the homes policies and procedures. What the service does well: What has improved since the last inspection?
All staff have now received training in the Protection of Vulnerable Adults. A system has been put into place that ensures staff files contain all the required documentation. Significant improvements have been made to the number of staff that holds an NVQ qualification.
Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 6 A planned schedule of formal supervision has now been introduced with records being maintained. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of the above standards were assessed at this inspection. Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of the above standards were assessed at this inspection. Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of the above standards were assessed at this inspection. Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Good practices and policies are in place to enable concerns to be raised and responded to. EVIDENCE: The home has a comprehensive complaints procedure, which is contained in the Service User Guide and provided to residents and their relatives upon admission. The home has received no complaints since the last inspection. Quality Assurance Questionnaires are sent out twice a year to relatives and residents inviting comments on the service provided, blank copies of these questionnaires are also left in the hallway for visitors to complete should they wish to make a positive or negative comment. The registered manager is keen for people to voice their opinions and promotes openness in order that improvements can be made to service provided. Relatives spoken to were aware of the home’s complaint procedure and stated that should they have any concerns they would have no hesitation in approaching the manager or a member of staff. Residents spoken to said they had no worries or concerns. One resident said, “The staff are wonderful I can not imagine what anyone would have to complain about.” The home has an abuse policy in place, which includes guidance on whistle blowing, abuse of residents and advice for staff on what could be perceived as abusive practice. This policy is based on the DOH document ‘No Secrets’ and is easily accessible by staff.
Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 12 Since the previous inspection formal training in the Protection of Vulnerable Adults has been provided to all staff and the registered manager said that this training would be provided to all new staff as they commence employment. Criminal Records Bureau (CRB) clearances were checked, however a number of staff have not yet received full CRB checks. The registered manager informed the inspector that all staff have been checked against the Protection of Vulnerable Adults Register (POVA), unfortunately evidence of these checks were not available in the home. The inspector requested that evidence of the POVA checks be forwarded to the Commission for Social Care Inspection. Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The standard of the environment within this home is good providing residents with an attractive and homely place to live. Systems are also in place to ensure a safe environment for those living there and visiting. EVIDENCE: Residents at Lindenwood Care Home live in well-maintained accommodation that is domestic in character and has been designed to meet the individual and collective needs of service users accommodated. Records are maintained in respect of the on-going maintenance and renewal programme of the home are maintained. Residents have access to a large, secluded landscaped garden area to the rear of the building that is provided with seating areas for residents to enjoy in the summer months. A passenger lift is provided for ease of access to all areas of the building. The registered manager conducts monthly environment checks to ensure the home complies with the requirements and recommendations of the
Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 14 Environmental Health Department and Health and Safety Executive. All hot water outlets in resident accommodation are provided with thermostatic devices to control the temperature of the hot water delivered and all radiators has been guarded in order to prevent accidental injury. The home’s policies and procedures in respect of infection control are extremely robust. All staff receives training in infection control and the registered manager promotes safe working practices at all times. All staff have to use alcohol hand wash after each task and visitors are asked to use the alcohol hand wash as they enter and leave the home. The home was clean and free from odours. Laundry facilities were sited away from kitchen and dining areas. The washing machine had appropriate programmes to ensure that all linen was cleaned at the temperatures required to control the risk of cross infection. Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, and 30 There is adequate staff employed to meet the needs of the residents. The arrangements for nationally recognised NVQ training has significantly improved. Staff demonstrated a clear understanding of their roles. The vetting and recruitment practices in respect of a number of recently appointed members of staff were inconsistent. Evidence was not available of appropriate checks being carried out EVIDENCE: Staffing levels at the Lindenwood Care Home reflect the needs and requirements of the residents accommodated. Since the previous inspection the number of staff achieving an NVQ qualification has significantly improved. It is pleasing to note that five members of staff have successfully completed a nationally recognised qualification in care at NVQ level 2 or above and the other care staff employed are currently undertaking this qualification or are awaiting a start date. Additional training is offered. At present a consultant has been appointed who is arranging training in a number of mandatory subjects. The inspector advised that all staff must be provided with training in all mandatory subjects and suggested that a training matrix be devised in order to track the training undertaken and provide information when refresher courses are due. Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 16 The home’s recruitment procedure has been reviewed and the registered manager has now constructed staff files to ensure all the required documents are maintained. Criminal Record Bureau (CRB) clearances were checked which revealed a number of new staff have not received their full CRB check. The registered manager stated that all staff have been checked against The Protection of Vulnerable Adults (POVA) register however evidence of these checks was not available at the inspection. The registered manager explained that she accepts telephone communication from the organisation responsible for processing the CRB clearances. Further investigation into why staff had not received either CRB or POVA checks revealed that, due to an administration issue, a number had not been processed resulting in staff working in the home that had not been appropriately checked to ensure the safety of the residents. The inspector advised that written communication of satisfactory clearances must be obtained prior to any new staff member taking up employment. In addition two written references must be obtained prior to the employment of new staff and verbal references used only as an interim measure. The inspector further advised that the application form could be improved by requesting prospective employees to declare any cautions received in addition to criminal convictions. Documents examined revealed that induction training is provided to all newly appointed staff. Whilst this training appears comprehensive in detail and meets the Skills for Care induction standards the inspector advised that the registered manager/trainer sign and date when training has been provided. Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 ,35 and 38 The home is managed in a way that supports staff to ensure residents receive consistent quality care. EVIDENCE: The home owner and manager work closely together and both are experienced in caring for the elderly. The manager is registered with The Commission for Social Care Inspection and is appropriately qualified. The registered manager demonstrated her commitment to providing a quality service based meeting the individual needs and wishes of the residents and frequently undertakes further training to ensure she keeps up with current good practice and changing legislation. Residents and staff spoke well of the management team and the care and support that they give. The Inspector was able to witness their approach to the residents and staff and confirm that comments made.
Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 18 Staff spoken to had a clear understanding of their role and what was expected of them. The Inspector saw documentation that confirmed that staff received regular supervision. There are good health and safety procedures in place with monthly health and safety checks being carried out on a monthly basis. Equipment is regularly serviced. The electrical installation certificate was not available and the homeowner was asked to locate this document and inform the Commission for Social Care Inspection that this certificate is still current. The heating system is to be replaced within the next few weeks. Staff are provided with training in all mandatory subjects, however the manager was asked to check all the records to ensure that staff do not ‘fall through the net’ and that all have actually undertaken training as stated in standard 38.1 and also to record when refresher courses are due to ensure that training and practice remain current. A fire risk assessment is in place, which is supported by regular checks on the fire alarm system and regular fire training. Further risk assessments are in place, which, ensures that the health, safety and welfare of the residents and staff are promoted and protected. Quality monitoring systems include internal systems, which invite feedback from people living at Lindenwood Care Home and their relatives in the form of anonymous questionnaires being issued twice a year. The findings of the questionnaires then inform how improvements to the service are to be implemented. Inspections of records for residents were comprehensive, well written and up to date. Records of money being handled by the homeowner for residents were up to date, explaining the reason for any expenditure and the balance of the money that was being retained. Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP29 OP30 Regulation 18 18 Requirement Criminal Record Bureau checks must be in place prior to any staff member taking up post. All training must be recorded in a format that clearly details the training undertaken and when refresher courses are due. Timescale for action 15/12/05 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP30 OP30 OP38 OP29 Good Practice Recommendations A training matrix should be developed/ Records of induction training provided should be signed by the manager/trainer. Evidence of the electrical installation certificate being in date should be forwarded to the Commission for Social Care Inspection. The application form could be improved by requesting that, prospective employees declare and cautions in addition to criminal convictions. Lindenwood Residential Care Home DS0000045504.V271567.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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